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Paroxysmal strabismus and stridor acquired in childhood: Do not overlook calcemia!
A Escudier1, E Giabicani2, B Neven3
1Service de Neurologie Pédiatrique, AP-HP, GHUEP, Hôpital Armand Trousseau, 75012 Paris, France.
Insights
Severe hypocalcemia, a calcium deficiency, can cause stridor and rarely strabismus. Prompt calcium level monitoring is crucial for diagnosing atypical neurological symptoms like those seen in this pediatric case.
Area of Science:
- Pediatric Neurology
- Endocrinology
- Genetics
Background:
- Hypocalcemia is a known cause of stridor.
- Hypocalcemia-induced strabismus is rarely documented.
- Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare genetic disorder affecting multiple endocrine glands.
Abstract:
Hypocalcemia is known to induce stridor but was rarely reported to cause strabismus. We report the case of a 4-year-old girl who presented with paroxysmal stridor and strabismus with diplopia, persisting for several weeks. Severe hypocalcemia (1.25 mmol/L) was finally diagnosed and was related to hypoparathyroidism, which was the first manifestation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in this patient. Strabismus and stridor both resolved after normalization of calcemia. This case report is a rare observation of paroxysmal strabismus caused by hypocalcemia and it highlights the importance of calcium monitoring in any situation of atypical neurological symptoms.
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